Abstract

Without sewers, more children die, and those who survive suffer in terms of physical growth and educational attainment. Donor policies and advice on sewers are wrong in three key respects. Sewers in cities are not optional extras but essential. Sewers need to be financed by taxation not user charges. And sewers in cities are affordable for most countries, many of whom are already investing in sewers in their cities. The aid needed is concentrated in a few countries, and this is affordable for rich countries.